Provider Demographics
NPI:1699978908
Name:SOUTH JERSEY WOMEN'S CENTER, P.C.
Entity type:Organization
Organization Name:SOUTH JERSEY WOMEN'S CENTER, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:BERNARD
Authorized Official - Last Name:DAINOFF
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:856-662-5282
Mailing Address - Street 1:1014 HADDONFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08002-2747
Mailing Address - Country:US
Mailing Address - Phone:856-662-5282
Mailing Address - Fax:856-662-5485
Practice Address - Street 1:1014 HADDONFIELD RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08002-2747
Practice Address - Country:US
Practice Address - Phone:856-662-5282
Practice Address - Fax:856-662-5485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-06
Last Update Date:2009-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB03433900202C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202C00000XAllopathic & Osteopathic PhysiciansIndependent Medical ExaminerGroup - Single Specialty